Provider Demographics
NPI:1922275890
Name:DALWADI, HEATHER (RPA-C)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:
Last Name:DALWADI
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5963 EXCHANGE DR STE 112
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-9256
Mailing Address - Country:US
Mailing Address - Phone:410-552-8126
Mailing Address - Fax:443-458-7220
Practice Address - Street 1:5963 EXCHANGE DR STE 112
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-9256
Practice Address - Country:US
Practice Address - Phone:410-552-8126
Practice Address - Fax:443-458-7220
Is Sole Proprietor?:No
Enumeration Date:2008-05-10
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
MDPA84069363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical